Media/Marketing Influences on Adolescent and Young Adult Substance Abuse
- 210 Downloads
Purpose of Review
We describe the state of research on substance use portrayals in marketing and media, considering exposure to tobacco, alcohol, e-cigarette, and marijuana content. Putative mechanisms are offered, and recommendations are made for effective prevention strategies for mitigating the influence of these portrayals.
There is consistent evidence that adolescents and young adults are highly exposed to substance use portrayals and that these portrayals are associated with subsequent substance use. Exposure via new media (social networking sites, brand Websites) has risen rapidly. Social norms and cognitions appear to at least partially account for the effects of portrayals on youth substance use.
Digital media has surpassed traditional marketing, which is concerning because youth have on-demand access to content and are active consumers of digital media. Developmentally appropriate media literacy interventions that include a parenting component and target multiple substances and media domains are recommended.
KeywordsAlcohol Smoking Media Advertising Marketing Adolescent Young adult
This work was supported by grants K02 AA13938 (PI: Jackson), T32 AA007459 (PI: Monti), and T34 DA037202 (PI: Budney).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Miech RA, Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the future national survey results on drug use, 1975–2016. Volume I: Secondary school students. Ann Arbor: Institute for Social Research, University of Michigan; 2017.Google Scholar
- 2.Schulenberg JE, Johnston LD, O’Malley PM, Bachman JG, Miech RA, Patrick ME. Monitoring the future national survey results on drug use, 1975–2016. Volume II: College students and adults ages 19–55. Ann Arbor: Institute for Social Research, University of Michigan; 2017.Google Scholar
- 5.•• Leonardi-Bee J, Nderi M, Britton J. Smoking in movies and smoking initiation in adolescents: systematic review and meta-analysis. Addiction. 2016;111(10):1750–63. This is a meta-analysis of 17 cross-sectional and longitudinal studies that indicate that higher exposure to smoking in movies is associated with increased risk of smoking initiation. PubMedCrossRefGoogle Scholar
- 6.•• Jernigan D, Noel J, Landon J, Thornton N, Lobstein T. Alcohol marketing and youth alcohol consumption: a systematic review of longitudinal studies published since 2008. Addiction. 2017;112(S1):7–20. This is a systematic review of longitudinal studies on alcohol marketing and youth alcohol consumption that reported significant associations between exposure to alcohol marketing and drinking initiation and subsequent heavy drinking. PubMedCrossRefGoogle Scholar
- 7.•• Stautz K, Brown KG, King SE, Shemilt I, Marteau TM. Immediate effects of alcohol marketing communications and media portrayals on consumption and cognition: a systematic review and meta-analysis of experimental studies. BMC Public Health. 2016;16(1):465. This systematic review and meta-analysis of experimental studies indicated that exposure to alcohol advertisements, but not portrayals in films or television, had an effect on immediate alcohol consumption. PubMedPubMedCentralCrossRefGoogle Scholar
- 8.•• Gupta H, Pettigrew S, Lam T, Tait RJ. A systematic review of the impact of exposure to internet-based alcohol-related content on young people’s alcohol use behaviours. Alcohol Alcohol. 2016;51(6):763–71. This systematic review reports significant associations between exposure to online alcohol content and describes how such peer-to-peer transmissions of marketers’ messages result in “intoxigenic” social environments. PubMedCrossRefGoogle Scholar
- 9.• Smith LA, Foxcroft DR. The effect of alcohol advertising, marketing and portrayal on drinking behaviour in young people: systematic review of prospective cohort studies. BMC Public Health. 2009;9(1):51. This is a review of longitudinal studies showing a moderate effect size between exposure to alcohol advertising, marketing, and portrayal and subsequent alcohol use in youth age 10-28 years old. PubMedPubMedCentralCrossRefGoogle Scholar
- 10.• Scott S, Muirhead C, Shucksmith J, Tyrrell R, Kaner E. Does industry-driven alcohol marketing influence adolescent drinking behaviour? A systematic review. Alcohol Alcohol. 2016;52(1):84–94. This paper found largely positive but still mixed associations between specific marketing components (Price, Promotion, Product attributes and Place of sale/availability) and alcohol use in youth age 9–17 years old, with the strongest positive associations with promotional activity (e.g., advertising of alcohol products or merchandise). PubMedPubMedCentralCrossRefGoogle Scholar
- 11.The Common Sense Census: Media Use by Tweens and Teens | Common Sense Media [Internet]. Available from: https://www.commonsensemedia.org/research/the-common-sense-census-media-use-by-tweens-and-teens. Accessed 23 Feb 2018
- 14.• Jernigan DH, Padon A, Ross C, Borzekowski D. Self-reported youth and adult exposure to alcohol Marketing in Traditional and Digital Media: results of a pilot survey. Alcohol Clin Exp Res. 2017;41(3):618–25. This was one of the first studies to compare alcohol advertising through traditional versus Internet/social media channels; youth were more likely than adults to report past exposure, particularly for Internet content. PubMedCrossRefGoogle Scholar
- 15.US Department of Health and Human Services. Preventing tobacco use among youth and young adults: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2012.Google Scholar
- 16.National Association of Attorneys General. Master Settlement Agreement. [Internet]. http://www.naag.org/assets/redesign/files/msa-tobacco/MSA.pdf (1998). Accessed 23 Feb 2018.
- 17.U.S. Food and Drug Administration. Family smoking prevention and tobacco control and federal retirement reform. [Internet]. https://www.gpo.gov/fdsys/pkg/PLAW-111publ31/pdf/PLAW-111publ31.pdf (2009).
- 26.International Center for Alcohol Policies. Guiding principles: self-regulation of marketing communications for beverage alcohol. [Internet]. 2011. http://www.iard.org/wp-content/uploads/2016/01/Guiding-Principles.pdf
- 28.•• Atkinson AM, Ross-Houle KM, Begley E, Sumnall H. An exploration of alcohol advertising on social networking sites: an analysis of content, interactions and young people’s perspectives. Addict Res Theory. 2017;25(2):91–102. This paper describes how social networking sites offer new and novel strategies to transmit alcohol marketing messages. CrossRefGoogle Scholar
- 29.Center on Alcohol Marketing and Youth. Youth exposure to alcohol product advertising on local radio in 75 U.S. markets, 2009. John Hopkins University, Baltimore, MD. 2011.Google Scholar
- 30.Center on Alcohol Marketing and Youth. Youth exposure to alcohol advertising on television, 2001-2009. John Hopkins University, Baltimore, MD. 2012.Google Scholar
- 32.• Collins RL, Martino SC, Kovalchik SA, Becker KM, Shadel WG, D’Amico EJ. Alcohol advertising exposure among middle school–age youth: an assessment across all media and venues. J Stud Alcohol Drugs. 2016;77(3):384–92. This was a novel study that used a 14-day ecological momentary assessment to quantify adolescent exposure to alcohol advertisements across media and venues (e.g., outdoors; television), and to indicate racial/ethnic differences with greater rates of exposure among African American and Hispanic youth as compared to non-Hispanic White youth. PubMedPubMedCentralCrossRefGoogle Scholar
- 37.• Babor TF. Editor’s corner: the role of public health surveillance in protecting young people from alcohol marketing. J Stud Alcohol Drugs. 2016;77(1):5–6. This is an Editorial urging public health researchers to monitor associations between alcohol marketing and youth alcohol consumption, citing plausible explanations supporting modifiable social and cognitive factors that may serve as mechanisms underlying these associations. PubMedCrossRefGoogle Scholar
- 44.• Duke JC, Lee YO, Kim AE, Watson KA, Arnold KY, Nonnemaker JM, et al. Exposure to electronic cigarette television advertisements among youth and young adults. Pediatrics. 2014;134(1):e29–36. In one of the first studies to examine youth and young adult exposure television advertisements for e-cigarettes, a behavior for which marketing is currently unregulated, a dramatic increase in youth and young adult e-cigarette exposure was observed. PubMedCrossRefGoogle Scholar
- 46.Agaku IT, Davis K, Patel D, Shafer P, Cox S, Ridgeway W, et al. A longitudinal study of the relationship between receptivity to e-cigarette advertisements and e-cigarette use among baseline non-users of cigarettes and e-cigarettes, United States. Tob Induc Dis. 2017;15(1):42.PubMedPubMedCentralCrossRefGoogle Scholar
- 47.• Mantey DS, Cooper MR, Clendennen SL, Pasch KE, Perry CL. E-cigarette marketing exposure is associated with e-cigarette use among US youth. J Adolesc Health. 2016;58(6):686–90. This study showed significant associations between e-cigarette marketing across multiple channels (internet, print, retail, TV/movies) and both use of and susceptibility to use ecigarettes among middle and high school students. PubMedPubMedCentralCrossRefGoogle Scholar
- 54.• Bierut T, Krauss MJ, Sowles SJ, Cavazos-Rehg PA. Exploring marijuana advertising on Weedmaps, a popular online directory. Prev Sci. 2017;18(2):183–92. This study found relatively unrestricted access to marijuana advertising on Weedmaps, an online marijuana retail website with associated social media, which made health claims about the benefits of marijuana. PubMedPubMedCentralCrossRefGoogle Scholar
- 55.• D’amico EJ, Miles JN, Tucker JS. Gateway to curiosity: medical marijuana ads and intention and use during middle school. Psychol Addict Behav. 2015;29(3):613–9. This study found reciprocal associations between exposure to advertising for medical marijuana and middle schooler marijuana use and intentions, suggesting the importance of regulating medical marijuana advertisements. PubMedPubMedCentralCrossRefGoogle Scholar
- 57.• Barry AE, Bates AM, Olusanya O, Vinal CE, Martin E, Peoples JE, et al. Alcohol marketing on twitter and Instagram: evidence of directly advertising to youth/adolescents. Alcohol Alcohol. 2016;51(4):487–92. This was an experimental study documenting that underage user profiles could access, view, and interact with alcohol industry content on Twitter and Instagram. PubMedCrossRefGoogle Scholar
- 59.Polansky JR, Titus K, Lanning N, Glantz SA. Smoking in top-grossing US movies, 2012. San Francisco: University of California San Francisco. 2013.Google Scholar
- 62.Escobedo P, Cruz TB, Tsai K-Y, Allem J-P, Soto DW, Kirkpatrick MG, Pattarroyo M, Unger JB Monitoring Tobacco Brand Websites to Understand Marketing Strategies Aimed at Tobacco Product Users and Potential Users, Nic Tob Res. 2017. ntx200. https://doi.org/10.1093/ntr/ntx200
- 67.• Pokhrel P, Fagan P, Herzog TA, Laestadius L, Buente W, Kawamoto CT, et al. Social media e-cigarette exposure and e-cigarette expectancies and use among young adults. Addict Behav. 2018;78:51–8. This study indicated that social media e-cigarette exposure was associated with young adult e-cigarette use and that this was mediated through outcome expectancies (positive “smoking” experience, positive sensory experience). PubMedCrossRefGoogle Scholar
- 69.• Richardson A, Ganz O, Vallone D. Tobacco on the web: surveillance and characterisation of online tobacco and e-cigarette advertising. Tob Control. 2015;24(4):341–7. Using meta-data from online banner/video advertising, this study found little evidence for cigarette smoking advertising but heavy advertising for e-cigarettes, which strongly featured messages of harm reduction or use for cessation. PubMedCrossRefGoogle Scholar
- 70.Hogg MA. Social identity theory. In: McKeown S., Haji R., Ferguson N. (eds) Understanding peace and conflict through social identity theory. 2016. Peace psychology book series. Springer, Cham. 2016. p. 3–17.Google Scholar
- 74.• Elmore KC, Scull TM, Kupersmidt JB. Media as a “super peer”: how adolescents interpret media messages predicts their perception of alcohol and tobacco use norms. J Youth Adolesc. 2017;46(2):376–87. This study showed associations between high school students’ media-related cognitions (e.g., similarity, realism, desirability, identification) and perceived social approval for and estimated prevalence of peer alcohol and tobacco use. PubMedCrossRefGoogle Scholar
- 75.McClure AC, Stoolmiller M, Tanski SE, Engels RC, Sargent JD. Alcohol marketing receptivity, marketing-specific cognitions, and underage binge drinking. Alcohol Clin Exp Res. 2013;37(suppl 1):E404–E413.Google Scholar
- 76.•• Nesi J, Rothenberg WA, Hussong AM, Jackson KM. Friends’ alcohol-related social networking site activity predicts escalations in adolescent drinking: mediation by peer norms. J Adolesc Health. 2017;60(6):641–7. This study investigates mediation by psychological mechanisms in the context of social media influences using longitudinal data. PubMedCrossRefGoogle Scholar
- 77.•• Janssen T, Cox MJ, Merrill JE, Barnett NP, Sargent JD, Jackson KM. Peer norms and susceptibility mediate the effect of movie alcohol exposure on alcohol initiation in adolescents. Psychol Addict Behav. 2017; Advance online publication. https://doi.org/10.1037/adb0000338. This study offers comprehensive longitudinal tests of mediation by multiple psychological mechanisms, prospectively predicting adolescent alcohol initiation.
- 78.Bandura A. Social learning theory. Englewood Cliffs, NJ: Prentice Hall; 1977.Google Scholar
- 89.Cukier SN, Gabrielli J, Bergamini E, Li Z, Sargent JD. Trends in alcohol brand placements in top U.S. movies, 1996–2015. San Francisco, CA: Pediatric Academic Societies Meeting; 2017.Google Scholar
- 105.• Young B, Lewis S, Katikireddi SV, Bauld L, Stead M, Angus K, et al. Effectiveness of mass media campaigns to reduce alcohol consumption and harm: a systematic review. Alcohol Alcohol 2018 https://doi.org/10.1093/alcalc/agx094. This was a systematic review that showed limited effectiveness of mass media public health campaigns to reduce alcohol consumption.
- 106.• Allara E, Ferri M, Bo A, Gasparrini A, Faggiano F. Are mass-media campaigns effective in preventing drug use? A Cochrane systematic review and meta-analysis. BMJ Open. 2015;5(9):e007449. This systematic review showed mixed effectiveness of mass media campaigns in reducing llicit drug consumption and intent to consume. PubMedPubMedCentralCrossRefGoogle Scholar
- 107.US Department of Health and Human Services, National Institutes of Health. The role of the media in promoting and reducing tobacco use. Bethesda: National Cancer Institute; 2008.Google Scholar
- 108.• Allen JA, Duke JC, Davis KC, Kim AE, Nonnemaker JM, Farrelly MC. Using mass media campaigns to reduce youth tobacco use: a review. Am J Health Promot. 2015;30(2):e71–e82. This review of antitobacco media campaigns to reduce youth smoking behavior or cognitions showed effectiveness across racial/ethnic populations, especially for campaigns with intense images, sound, and editing and that include personal testimonials. CrossRefGoogle Scholar
- 122.• Primack BA, Douglas EL, Land SR, Miller E, Fine MJ. Comparison of media literacy and usual education to prevent tobacco use: a cluster-randomized trial. J Sch Health. 2014;84(2):106–15. This study showed the effectiveness of a school-based anti-smoking program for teaching media literacy and altering perceptions of the prevalence of smoking among adolescents. PubMedPubMedCentralCrossRefGoogle Scholar
- 130.• Cox, MJ, Gabrielli JL, Janssen T, Jackson KM. Parental restriction of movie viewing prospectively predicts adolescent alcohol and marijuana initiation: implications for media literacy programs. Prev Sci (in press). This study showed that parental restriction of R-rated movies was protective of both alcohol and marijuana initiation, with youth who reported watching R-rated films despite parental restrictions at heightened risk for alcohol initiation. Google Scholar
- 131.Shin Y, Miller-Day M, Pettigrew J, Hecht ML, Krieger JL. Typology of delivery quality: latent profile analysis of teacher engagement and delivery techniques in a school-based prevention intervention, keepin’it REAL curriculum. Health Educ Res. 2014;29(6):897–905.PubMedPubMedCentralCrossRefGoogle Scholar
- 135.•• Collier KM, Coyne SM, Rasmussen EE, Hawkins AJ, Padilla-Walker LM, Erickson SE, et al. Does parental mediation of media influence child outcomes? A meta-analysis on media time, aggression, substance use, and sexual behavior. Dev Psychol. 2016;52(5):798. This study used meta-analysis to examine the role of parental mediation behaviors on the association between media influence and child behavior outcomes. Parental active mediation provided a protective effect for child risk for substance use. PubMedCrossRefGoogle Scholar